Childhood Speech Sound Disorders Research Articles

Toward Process-Oriented, Dimensional Approaches for Diagnosis and Treatment of Speech Sound Disorders in Children: Position Statement and Future Perspectives.

Children with speech sound disorders (SSD) form a heterogeneous group, with respect to severity, etiology, proximal causes, speech error characteristics, and response to treatment. Infants develop speech and language in interaction with neurological maturation and general perceptual, motoric, and cognitive skills in a social-emotional context. After a brief introduction into psycholinguistic models of speech production and levels of causation, in this review article, we present an in-depth overview of mechanisms and processes, and the dynamics thereof, which are crucial in typical speech development. These basic mechanisms and processes are: (a) neurophysiological motor refinement, that is, the maturational articulatory mechanisms that drive babbling and the more differentiated production of larger speech patterns; (b) sensorimotor integration, which forms the steering function from phonetics to phonology; and (c) motor hierarchy and articulatory phonology describing the gestural organization of syllables, which underlie fluent speech production. These dynamics have consequences for the diagnosis and further analysis of SSD in children. We argue that current diagnostic classification systems do not do justice to the multilevel, multifactorial, and interactive character of the underlying mechanisms and processes. This is illustrated by a recent Dutch study yielding distinct performance profiles among children with SSD, which allows for a dimensional interpretation of underlying processing deficits. Analyses of mainstream treatments with respect to the treatment goals and the speech mechanisms addressed show that treatment programs are quite transparent in their aims and approach and how they contribute to remediating specific deficits or mechanisms. Recent studies into clinical reasoning reveal that the clinical challenge for speech-language pathologists is how to select the most appropriate treatment at the most appropriate time for each individual child with SSD. We argue that a process-oriented approach has merits as compared to categorical diagnostics as a toolbox to aid in the interpretation of the speech profile in terms of underlying deficits and to connect these to a specific intervention approach and treatment target.

Considerations for identifying subtypes of speech sound disorder.

Speech sound disorders (SSDs) in children are heterogeneous. Differentiating children with SSDs into distinct subtypes is important so that each child receives a treatment approach well suited to the particular difficulties they are experiencing. To study the distinct underlying processes that differentiate phonological processing, phonological planning or motor planning deficits. The literature on the nature of SSDs is reviewed to reveal diagnostic signs at the level of distal causes, proximal factors and surface characteristics. Subtypes of SSDs may be identified by linking the surface characteristics of the children's speech to underlying explanatory proximal factors. The proximal factors may be revealed by measures of speech perception skills, phonological memory and speech-motor control. The evidence suggests that consistent phonological disorder (CPD) can be identified by predictable patterns of speech error associated with speech perception errors. Inconsistent phonological disorder (IPD) is associated with a deficit in the selection and sequencing of phonemes, that is, revealed as within-word inconsistency and poor phonological memory. The motor planning deficit that is specific to childhood apraxia of speech (CAS) is revealed by transcoding errors on the syllable repetition task and an inability to produce [pətəkə] accurately and rapidly. Children with SSDs form a heterogeneous population. Surface characteristics overlap considerably among those with severe disorders, but certain signs are unique to particular subtypes. Careful attention to underlying causal factors will support the accurate diagnosis and selection of personalized treatment options. What is already known on the subject SSD in children are heterogenous, with numerous subtypes of primary SSD proposed. Diagnosing the specific subtype of SSD is important in order to assign the most efficacious treatment approach for each child. Identifying the distinct subtype for each child is difficult because the surface characteristics of certain subtypes overlap among categories (e.g., CPD or IPD; CAS). What this paper adds to the existing knowledge The diagnostic challenge might be eased by systematic attention to explanatory factors in relation to the surface characteristics, using specific tests for this purpose. Word identification tasks tap speech perception skills; repetition of short versus long strings of nonsense syllables permits observation of phonological memory and phonological planning skills; and standard maximum performance tests provide considerable information about speech motor control. What are the potential or actual clinical implications of this work? Children with SSDs should receive comprehensive assessments of their phonological processing, phonological planning and motor planning skills frequently, alongside examinations of their error patterns in connected speech. Such assessments will serve to identify the child's primary challenges currently and as they change over developmental time.

Automatic detection of speech sound disorder in children using automatic speech recognition and audio classification*

Automatic detection of speech sound disorder in children using automatic speech recognition and audio classification*

Speech sound error patterns may signal language disorder in Swedish preschool children with autism.

Within cohorts of children with autism spectrum disorder (ASD) there is considerable variation in terms of language ability. In the past, it was believed that children with ASD either had delayed articulation and phonology skills or excelled in those areas compared to other language domains. Very little is known about speech sound ability in relation to language ability and non-verbal ability in Swedish preschool children with ASD. The current study aimed to describe language variation in a group of 4-6-year-old children with ASD, focusing on in-depth analyses of speech sound error patterns with and without non-phonological language disorder and concomitant non-verbal delays. We examined and analysed the speech sound skills (including consonant inventory, percentage of correct consonants and speech sound error patterns) in relation to receptive language skills in a sample of preschool children who had screened positive for ASD in a population-based screening at 2.5 years of age. Seventy-three children diagnosed with ASD participated and were divided into subgroups based on their receptive language (i.e., non-phonological language) and non-verbal abilities. The subgroup division revealed that 29 children (40%) had language delay/disorder without concurrent non-verbal general cognitive delay (ALD), 27 children (37%) had language delay/disorder with non-verbal general cognitive delay (AGD), and 17 children (23%) had language and non-verbal abilities within the normal range (ALN). Results revealed that children with ALD and children with AGD both had atypical speech sound error patterns significantly more often than the children with ALN. This study showed that many children who had screened positive for ASD before age 3 years - with or without non-verbal general cognitive delays - had deficits in language as well as in speech sound ability. However, individual differences were considerable. Our results point to speech sound error patterns as a potential clinical marker for language problems (disorder/delay) in preschool children with ASD. What is already known on the subject Children with autism spectrum disorder (ASD) have deficits in social communication, restricted interests and repetitive behaviour. They show very considerable variation in both receptive and expressive language abilities. Previously, articulation and phonology were viewed as either delayed in children with ASD or superior compared with other (non-phonological) language domains. What this paper adds to existing knowledge Children with ASD and language disorders also have problems with speech sound error patterns. What are the potential or actual clinical implications of this work? About 75% of children with ASD experience language delays/disorders, as well as speech sound problems, related to speech sound error patterns. Understanding/acknowledging these phonological patterns and their implications can help in the diagnosis and intervention of speech sound disorders in children with ASD. Direct intervention targeting phonology might lead to language gains, but more research is needed.

Feasibility of using ultrasound visual biofeedback to treat persistent speech sound disorders in children with cleft palate- a case series

ABSTRACT The current study aimed to assess the effectiveness of incorporating ultrasound visual biofeedback (UVB) into a treatment programme addressing persistent speech sound disorders linked to cleft palate in children who have been unresponsive to traditional therapy approaches. Materials and Methods. A single-subject multiple baseline experiment was conducted with five children aged 6:5–13:5 over a period of 16 therapy sessions. Treatment focused on providing cues from real-time ultrasound images to assist children in modifying their tongue movements. Probe data were collected before, mid, and post-treatment to assess target consonant accuracy for 50 untreated words. The results of the statistical analysis suggested participants showed a significant increase in percent target consonant accuracy as a result of intervention using UVB. Although most of the participants exhibited progress in generalising learned phonemes to untreated words, some did not show improvement in gaining generalisation from treated phonemic contexts to those untreated ones. When traditional methods fail to yield significant progress, incorporating ultrasound biofeedback into the treatment programme emerges as a viable option to enhance sound accuracy in children with persistent speech sound disorders resulting from cleft palate.

In an EFL Environment: Characteristics of Speech Sound Disorders in Children’s English Articulation

Objectives: In an EFL (English as a Foreign Language) environment like Korea, individuals learn English through education, and learning a foreign language is naturally influenced by the language system of the mother tongue. This study aimed to investigate the English speech characteristics and patterns of native language transfer in children with speech sound disorders (SSD).Methods: 20 Korean children aged 4-6 years participated in this study. The study divided participants into SSD and normal speech acquisition (NSA) groups, each comprising 10 children. Participants completed English word repetition task using the Diagnostic Evaluation of Articulation and Phonology (DEAP). Additionally, the SSD group was assessed using the Urimal Test of Articulation & Phonology (U-TAP) to compare differences in speech production based on language types. In both groups, the overall consonant accuracy, error types an error patterns in English were analyzed. English error types were categorized as substitution, vowel addition, consonant addition, vowel deletion, consonant deletion, inter-language distortion and intra-language distortion. Error patterns were further divided into developmental and non-developmental error patterns.Results: The SSD group demonstrated lower consonant accuracy compared to the NSA group in English articulation. Significant differences were observed between the two groups in vowel deletion rates and minor variations in consonant addition patterns. Error pattern analysis revealed that both groups exhibited a high proportion of stopping and final consonant deletion.Conclusion: This study directly confirmed the transfer of native language deficits in children with SSD to their English articulation and indirectly suggested that underlying deficits might impact English speech production.

APPLICATION OF MOTOR SENSORY APPROACH TO IMPROVE ARTICULATION SKILLS IN CHILDREN WITH INTELLECTUAL DISABILITIES

Several studies have shown that speech sound disorders in children with intellectual disabilities impact communication with their environment. They have more difficulty with expressive language and speech intelligibility than receptive. Interventions are needed to improve speech skills, especially in articulation skills. Purpose: This study aims to determine the effect of sensory motor methods in improving articulation skills. Method: using a single subject experiment, using a one group pretest-posttest design. The participant is a girl aged 7:6 years old with articulation disorder on consonants /p/, /b/, /m/, /n/, /w/, /t/, /d/, /k/, /g/, /ŋ/, /j/, /c/, /f/, /w/, /v/, /h/, /r/, /y/, /z/, /fr/, /br/, /dw/, /gr/, /kl/, /pr/, /sk/, /sp/, /st/, /sw/. Data collection was done through interviews with the client's parents, direct observation of the client, and tests. Speech therapy was conducted for 10 sessions with an emphasis on sensory-motor integration. Perceptual assessment was carried out by comparing the ability to produce the phoneme /p/ in the initial position of the word with a combination of vowels /a/ before and after therapy. Results: in the post speech therapy assessment, there was an increase of 40%. Conclusion: from the therapy activities for 10 session with the Sensory Motor Approach, the client was quite successful in producing /p/ in the initial position of the word with a combination of vowels /a/. Suggestion: this study suggests designing a therapy cycle in order to find out the effectiveness of the Sensory Motor Approach more deeply.

The Relationship Between Speech Perception, Speech Production, and Vocabulary Abilities in Children: Insights From By-Group and Continuous Analyses.

The purpose of this study was to explore the relationship between speech perception, speech production, and vocabulary abilities in children with and without speech sound disorders (SSDs), analyzing the data both by group and continuously. Sixty-one Australian English-speaking children aged 48-69 months participated in this study. Children's speech production abilities ranged along the continuum from SSDs through to typical speech. Their vocabulary abilities ranged along the continuum from typical to above average ("lexically precocious"). Children completed routine speech and language assessments in addition to an experimental Australian English lexical and phonetic judgment task. When analyzing data by group, there was no significant difference between the speech perception ability of children with SSDs and that of children without SSDs. Children with above-average vocabularies had significantly better speech perception ability than children with average vocabularies. When analyzing data continuously, speech production and vocabulary were both significant positive predictors of variance in speech perception ability, both individually in simple linear regression and when combined in multiple linear regression. There was also a significant positive correlation between perception and production of two of the four target phonemes tested (i.e., /k/ and /ʃ/) among children in the SSD group. Results from this study provide further insight into the complex relationship between speech perception, speech production, and vocabulary abilities in children. While there is a clinical and important need for categorical distinctions between SSDs and typically developing speech, findings further highlight the value of investigating speech production and vocabulary abilities continuously and categorically. By capturing the heterogeneity among children's speech production and vocabulary abilities, we can advance our understanding of SSDs in children. https://doi.org/10.23641/asha.22229674.

Association of non-nutritive sucking habits with speech sound disorders: A scoping review

The impact of non-nutritive sucking (NNS) habits on dentofacial structures and occlusion is well proven. It has been hypothesised that NNS also effect speech due to its effect on dentition and oral musculature. However, the results of the existing studies are inconsistent, therefore this scoping review was undertaken to systemically evaluate the existing literature and to identify any research gaps. The database search resulted in 869 studies of which 861 articles were excluded as they were duplicates, irrelevant, published in languages other than English, and data were not available. The remaining 8 full-text articles were evaluated for their eligibility and were included in the present review. After the qualitative analysis of the studies, we conclude that the non-nutritive sucking is associated with speech sound disorders in children. However, the of quality of evidence is not satisfactory, more studies with detailed measures of sucking habits are needed to completely understand the effect of NNS on speech disorders.

Nonspeech Oral Motor Exercises: Use and Knowledge of Speech-Language Pathologists Working with People with Speech Sound Disorders

Previous studies, conducted in different countries (e.g. Australia, Canada, India, Republic of Ireland, USA, UK), have shown that speech-language pathologists (SLPs) use nonspeech oral motor exercises (NSOMEs) to treat speech sound disorders (SSDs), bringing attention to the substantial debate regarding the clinical effectiveness of NSOMEs. The aim of the present study was to investigate and characterize the use of NSOMEs by Portuguese SLPs in the intervention of SSDs, and to analyze the evidence that supports it. To do so, SLPs who provide therapy to children with SSDs were invited to complete an online questionnaire, based on a previous survey conducted in India by Thomas and Kaipa (2015). A total of 184 participants responded to the survey; 93.5% reported knowing about NSOMEs, 78.5% used NSOMEs in their intervention for SSDs, and 80.2% considered them effective in treating SSDs (89% indicated that their knowledge about NSOMEs was acquired through graduate and post-graduate courses; 98.5% reported that they used NSOMEs to improve the motor function of the articulators). This study offers an overview of Portuguese speech-language pathologists’ reported use of NSOMEs as part of the intervention of speech sound disorders in children. Many of the participants in this study reported that they did use NSOMEs in SSD treatments, regardless of the lack of evidence to support their use in this context. Furthermore, the results show that the percentage of SLPs in Portugal using NSOMEs is similar to those found in the USA, UK, Canada, and India, but different from those in Australia and Ireland.

Relationship Between Speech Sound Disorders and Neuropsychological Skills (Language and Attention skills) in Children Mediated by Parenting Styles and Maternal Depression

Background and Aims Speech sound disorder (SSD) is a type of communication disorders in children where normal process of speech sound learning is disrupted. Children with SSD have errors in the expression of speech sounds that can make it difficult for others to understand what they say. The present study aims to assess the relationship of neuropsychological skills (language and attention skills) with SSD mediated by the parenting styles (authoritarian, authoritative, and permissive) and maternal depression. Methods This is an analytical, descriptive, correlational study using structural equation modeling (SEM). A total of 117 preschool children agef 4–6 years with SSD and their mothers were recruited using a purposive sampling method from among those refereed to speech and language therapy clinics and kindergartens in Isfahan, Iran. The SSD was screened using the test proposed by Ahmadi et al. Conners’ neuropsychological assessment test, Baumrind’s parenting style inventory, and Beck depression inventory were completed by the mothers of children. The data were analyzed in AMOS software using the correlation test, regression analysis, path analysis, and SEM. Results The statistical analysis showed that the correlation of language skills with SSD was significant (P=0.019 <0.05). However, the correlation was not significant when mediated by the parenting styles (P=0.665 for authoritarian style; P=0.306 for authoritative style; P=0.164 for permissive style) and maternal depression (P=0.546>0.05). On the other hand, the correlation of attention skills with SSD was not significant (P=0.361 >0.05), not even after medication by the parenting styles (P=0.686 for authoritarian style; P=0.315 for authoritative style; P=0.849 for permissive style) and maternal depression (P=0.393>0.05). However, in the attention model, the correlation of permissive parenting style with SSD was significant (P=0.026 <0.05). Conclusion Language skills have a significant direct correlation with SSD in children, indicating that the increase of language problems in children can increase their errors in making sounds (phonemes). The attention skills has no significant correlation with SSD even after mediation by the parenting styles and maternal depression. The permissive parenting style has a significant negative correlation with SSD.

Effects of Preschool Speech Sound Disorder on School Age Activities · Participation

Purpose: Childhood speech sound disorders are related to a variety of problems, and it is important to identify and minimize problems. This study divided groups based on speech abilities and examined differences in the developmental trajectories of activities ∙ participation, and the effect of child factors and environmental factors on the developmental trajectories in activities ∙ participation.Methods: Using the Panel Study on Korean children for the 7th and 9th years, the groups were classified into typically developing, having mild speech sound disorder, and having moderate speech sound disorder based on speech ability. Through multilevel growth model analysis, each group was examined for developmental trajectories in activities ∙ participation in the first and second grades and analyzed the impact of child factors and environmental factors on developmental trajectories.Results: The group with speech sound disorders received low rating scores in various areas of activities ∙ participation in the first and second grades. The child factors and environmental factors contained different effects on each group. Activities ∙ participation of speech sound disorders affected the executive function, school preference, school environment, school location, and childcare policies.Conclusion: This study provides a basis for the need for various types of institutional support to be provided to children with speech sound disorders by showing the effect of speech sound disorders on the performance of children’s life functions, and by examining the effect of child factors and environmental factors on the patterns of developmental trajectories.

Using ultrasound tongue imaging to support the phonetic transcription of childhood speech sound disorders

ABSTRACT This study aims to determine whether adding an additional modality (ultrasound tongue imaging) improves the inter-rater reliability of phonetic transcription in childhood speech sound disorders (SSDs) and whether it enables the identification of different or additional errors in children’s speech. Twenty-three English speaking children aged 5–13 years with SSDs of unknown origin were recorded producing repetitions of /aCa/ for all places of articulation with simultaneous audio and ultrasound. Two types of transcriptions were undertaken off-line: (1) ultrasound-aided transcription by two ultrasound-trained speech-language pathologists (SLPs) and (2) traditional phonetic transcription from audio recordings, completed by the same two SLPs and additionally by two different SSD specialist SLPs. We classified transcriptions and errors into ten different subcategories and compared: the number of consonants identified as in error by each transcriber; the inter-rater reliability; and the relative frequencies of error types identified by the different types of transcriber. Results showed that error-detection rates were different across the transcription types, with the ultrasound-aided transcribers identifying more errors than were identified using traditional audio-only transcription. Analysis revealed that these additional errors were identified on the dynamic ultrasound image despite being transcribed as correct, suggestive of subtle motor speech differences. Interrater reliability for classifying the type of error was substantial (κ = 0.72) for the ultrasound-aided transcribers and ranged from fair to moderate for the audio-only transcribers (κ = 0.38 to 0.52). Ultrasound-aided transcribers identified more instances of increased variability and abnormal timing errors than the audio-only transcribers.

TỔNG QUAN CÁC TIÊU CHUẨN CHẨN ĐOÁN RỐI LOẠN ÂM LỜI NÓI Ở TRẺ EM

Speech sound disorders (SSD) is a common communication disorder with long-term consequences in children. Diagnosis and assessment play an important role in the identification of SSD and its severity, to assist goal setting and intervention planning and to measure progression. In order to define and describe diagnostic criteria regarding SSD in children, this review paper uses content analysis of 14 studies reporting on children with SSD. Results reveal that diagnostic criteria for SSD in children include: 1) Mean scores of percentage phonemes correct (e.g., percentage of consonants correct, PCC, and percentage of vowels correct, PVC); 2) phonological processes; 3) “concern” from parents, teachers, and children themselves about children’s speech and pronunciation; and 4) children's speech intelligibility. While mean scores of the percentage of consonants correct were varied between studies, diagnostic criteria for identifying SSD were achieving a PCC score between one and two standard deviations below the mean for the child’s age. Some children with SSD were reported to use phonological processes that are occasional (>10%) and rare (>5%), or are still being used at an older age compared to typically developing children. Many children with SSD had parents and teachers who were concerned about their speech and pronunciation. Mean scores of young children’s speech intelligibility measured by the Intelligibility in Context Scale were typically below 4.0. This review provides useful information and a foundation for research and clinical practice in a language in which diagnosis criteria for SSD have not been established.

A survey of Swedish speech-language pathologists’ practices regarding assessment of speech sound disorders

Purpose To explore Swedish clinical practice regarding assessment of suspected Speech Sound Disorders (SSD) in children. Methods A web-based questionnaire, regarding assessment of SSD in children 4;6–6;11 (years; months), was distributed to Swedish speech-language pathologists (SLPs) through social media and online forums. The questions concerned the frequency and manner of assessment for seven assessment components, chosen based on a review of international recommendations for SSD assessment. Results A total of 131 SLPs responded to the questionnaire. The results show that Swedish SSD assessment practices vary with regards to the frequency and manner of assessment for many components. Speech output is frequently assessed while speech perception, phonological awareness and oral-motor function are assessed less frequently. A variety of manners of assessment, for example, standardised tests, non-standardised material, and informal assessment procedures, such as observation, are utilized by respondents. Conclusions Swedish SSD assessment practices are variable. The present paper reveals areas for development within SLP practice and education programmes, and provides a new perspective on present praxis with regards to the assessment of suspected SSD in Sweden.

Speech input processing in children born with cleft palate: A systematic literature review with narrative synthesis.

BackgroundSpeech development requires intact and adequately functioning oral anatomy and cognitive ‘speech processing’ skills. There is evidence that speech input processing skills are associated with speech output problems in children not born with a cleft. Children born with cleft palate ± lip (CP±L) are at high risk of developing disordered speech output. Less is known about their speech input processing skills and whether they are associated with cleft‐related speech sound disorder (SSD).Aims(1) To collate and evaluate studies reporting evidence regarding the speech input processing skills of children born with cleft palate in comparison with data from typically developing children or other comparison groups; and (2) to identify any available evidence regarding relationships between speech input processing skills and speech output in children born with CP±L.Methods & ProceduresPotentially relevant studies published up to November 2019 were identified from the following databases: Medline via Ovid, Embase via Ovid, Cinahl via Ebscohost, PsycInfo via Ebscohost, BNI via ProQuest, AMED via Ovid, Cochrane Library and Scopus. Inclusion criteria were: peer‐reviewed articles published in scientific journals, any design, published in English, participants born with a CP±L aged up to age 18 years who completed speech input processing assessments compared with normative data and/or a control or other comparison group. Critical Appraisal Skills Programme (CASP) checklists were used to quality appraise included studies.Outcomes & ResultsSix studies were retained in the final review. There is some evidence that children born with CP±L perform less well than non‐cleft controls on some speech input processing tasks and that specific input processing skills may be related to errors in the children's speech. Heterogeneity in relation to study groups and assessments used, as well as small sample sizes, limits generalization of findings.Conclusion & ImplicationsThere is limited evidence regarding the speech input processing skills of children born with CP±L. There are indications that children born with CP+/L may have difficulty in some aspects of speech input processing in comparison with children not born with a cleft, and that difficulties with some speech input processing tasks may be specific to errors in children's speech output. Further research is required to develop our understanding of these skills in this population and any associations with speech output.What this paper addsWhat is already known on the subject Few studies have been published that examine aspects of speech input processing in children born with CP±L. Theoretical models of speech processing, and published studies, propose that speech input processing skills are associated with SSD in children who were not born with a cleft. However, it is less clear whether there is any association between speech input processing and cleft‐related SSD. What this paper adds to existing knowledge This review systematically collates and evaluates the published, peer‐reviewed evidence regarding speech input processing skills in children born with CP±L. The collated evidence indicates that some speech input processing skills differ between children with and without CP±L. There is some evidence, from a single study, that speech input processing of specific cleft speech characteristics (CSCs) may be associated with the presence of these CSCs in the speech output of some children born with CP±L. What are the potential or actual clinical implications of this work? While the evidence is currently limited, increasing our knowledge of speech input processing skills in children born with CP±L contributes to our clinical understanding of the nature of cleft‐related SSD. The current evidence suggests that speech and language therapists should consider speech input processing skills when assessing children with cleft‐related SSD to support intervention planning. Considering these skills in relation to literacy development in these children may also be important.

Treating Childhood Speech Sound Disorders: Current Approaches to Management by Australian Speech-Language Pathologists.

Purpose This study explored the intervention processes used by speech-language pathologists (SLPs) to treat children with speech sound disorders (SSDs). Method Semistructured, individual, in-depth interviews were conducted with 11 Australian SLPs. Inductive content analysis was used to classify the data to provide a description of current intervention processes for children with SSDs. Results Three main factors were identified relating to the intervention processes used by SLPs: (a) target selection, (b) therapy approaches, and (c) structural and procedural aspects of therapy sessions, including feedback. The findings revealed that SLPs often combine elements of four therapies: the minimal pairs approach, traditional articulatory approaches, auditory discrimination, and Cued Articulation. Initial therapy targets typically aligned with a developmental approach or were functional speech targets with meaningful relevance to the child and their family. Conclusions These findings contribute to the current state of knowledge about the intervention processes used by SLPs for children with SSDs. The use of hybrid speech pathology therapies, which combined elements of favored approaches, was common. Hybrid methods were intended to help tailor the interventions to individual needs. Client needs were highly prioritized by SLPs and influenced their choice of therapy targets and therapy approaches.

Use of ultrasound visual feedback in speech intervention for children with cochlear implants

ABSTRACT The purpose of the present study was to evaluate the efficacy of ultrasound visual feedback in speech intervention for young children with cochlear implants. Although ultrasound technology has been used for intervention in children with speech sound disorders, there is little systematic evidence regarding relative efficacy of ultrasound visual feedback for young children with cochlear implants. Two children with cochlear implants participated in this study. The children’s articulation was tested using Goldman-Fristoe Test of Articulation-2 and probes. Therapy was provided semi-weekly for 30-minute sessions over the course of nine to 10 weeks. Visual inspection showed an increasing trend in production accuracy to the criterion accuracy of 80% for target sounds. Maintenance of skills were observed at two weeks and two months post-intervention. The results of this study indicated that ultrasound visual feedback is likely an effective intervention tool for treating speech sound disorders in children with cochlear implants. Future studies including a larger sample size should be conducted to verify these findings.

Speech Sound Disorders in Children: An Articulatory Phonology Perspective.

Speech Sound Disorders (SSDs) is a generic term used to describe a range of difficulties producing speech sounds in children (McLeod and Baker, 2017). The foundations of clinical assessment, classification and intervention for children with SSD have been heavily influenced by psycholinguistic theory and procedures, which largely posit a firm boundary between phonological processes and phonetics/articulation (Shriberg, 2010). Thus, in many current SSD classification systems the complex relationships between the etiology (distal), processing deficits (proximal) and the behavioral levels (speech symptoms) is under-specified (Terband et al., 2019a). It is critical to understand the complex interactions between these levels as they have implications for differential diagnosis and treatment planning (Terband et al., 2019a). There have been some theoretical attempts made towards understanding these interactions (e.g., McAllister Byun and Tessier, 2016) and characterizing speech patterns in children either solely as the product of speech motor performance limitations or purely as a consequence of phonological/grammatical competence has been challenged (Inkelas and Rose, 2007; McAllister Byun, 2012). In the present paper, we intend to reconcile the phonetic-phonology dichotomy and discuss the interconnectedness between these levels and the nature of SSDs using an alternative perspective based on the notion of an articulatory “gesture” within the broader concepts of the Articulatory Phonology model (AP; Browman and Goldstein, 1992). The articulatory “gesture” serves as a unit of phonological contrast and characterization of the resulting articulatory movements (Browman and Goldstein, 1992; van Lieshout and Goldstein, 2008). We present evidence supporting the notion of articulatory gestures at the level of speech production and as reflected in control processes in the brain and discuss how an articulatory “gesture”-based approach can account for articulatory behaviors in typical and disordered speech production (van Lieshout, 2004; Pouplier and van Lieshout, 2016). Specifically, we discuss how the AP model can provide an explanatory framework for understanding SSDs in children. Although other theories may be able to provide alternate explanations for some of the issues we will discuss, the AP framework in our view generates a unique scope that covers linguistic (phonology) and motor processes in a unified manner.

소아의 말소리 장애

소아의 말소리 장애